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Citation: Derbyshire, Julie, Ford, Claire and Stephenson, Stewart (2019) An evaluation study of a blended learning approach to teaching neurological observations using Kirkpatricks model. In: North East Simulation Network Event, 21st March 2019, Newcastle Upon Tyne, UK.

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An evaluation study of a blended learning approach to teaching neurological

observations using Kirkpatrick's model

References

• Department of Health (2011) A Framework for Technology Enhanced Learning. London: Department of Health Publications.

• Doyle, S., Moore, M., Murphy, L. and Sewell, G. (2017) Embedding a blended learning approach from first year. Dublin: Dublin Institute of Technology.

• Griswold, S. K. et al. (2012) ‘The emerging role of simulation education to achieve patient safety translating deliberate practice and debriefing to save lives’, Pediatric Clinics of North America, 59(6), pp. 1329-1340.

• Kirkpatrick, D.L. and Kirkpatrick, J.D. (2006) Evaluating training programs: the four levels. 3rd edn. San Francisco: Berret-Koehler Publishers.

• McCutcheon, K., Lohan, M., Traynor, M. and Martin, D. (2014) ‘A systematic review evaluating the impact of online or blended learning vs face to face learning of clinical skills in undergraduate nurse education’, Journal of Advanced Nursing, 71(2), pp. 255-270.

• NICE (2014) Head injury: triage assessment, investigation and early management of head injury in infants, children and adults London: NICE.

• Rapp, A. K. et al. (2016) ‘YouTube is the most frequently used educational video source for surgical preparation’, Journal of Surgical Education, 73(6), pp. 1072-1076.

• Schmidt, H. G. et al. (2015) ‘On the use and misuse of lectures in higher education’, Health Professions Education, 1(1), pp. 12-18.

Resources

BackgroundCurrent students accessing higher education are technologically savvy and possess learning styles which vary considerably to their previous counterparts. Consequently, academic institutionsmust expand their pedagogical repertoire, in order to remain contemporary and cost-efficient (McCutheon et al., 2014). However, within healthcare education the increased focus on patientsafety suggests that certain aspects of practice need to be repeatedly reinforced, and opportunities must be made available in order for students to develop competence in clinical skills.Neurological observations are one of the skills that need to be performed by appropriately trained staff and recorded accurately (NICE, 2014), as acute neurological conditions have an urgencythat makes their rapid diagnosis and treatment crucial for improving outcomes.

Blended learning incorporating face-to-face teaching, online learning activities and high-fidelity simulation aim to strengthen knowledge and help students to relate theory to practice (Doyleet al., 2017). However, it is essential to examine the effectiveness of such innovative approaches in terms of student learning, changes in behaviour and educational outcomes. Therefore, theblended learning approach to teaching neurological observations is being explored through a collaborative project involving clinicians and academics, which utilises online resources,traditional didactic lectures, and human simulation with year two undergraduate nursing students.

Methods

Online self directed learning

Study design

Student Evaluation

Way forward

CONTACT DETAILSDr Julie Derbyshire, Senior Lecturer,

Northumbria University. Email: julie.derbyshire@northumbria.ac.uk

Claire Ford, Lecturer, Northumbria University.

Stewart Stephenson, Clinical Educator, Royal Victoria Infirmary.

Practical simulation

Classroom based knowledge transferLectures and didactic approaches to information transmission is a long heldtradition within higher education institutions. Whilst debates about theeffectiveness of this teaching medium are ongoing, what has been agreed, it thatwhen knowledge transfer is undertaken by academics who are experts in the field,have the ability to explain concepts in simplistic and more relatable terms, and arealso charismatic teachers, information exchange and retention can be achieved(Schmidt et al., 2015). For this research project, a lecturer with all of the abovequalities, undertook a two hour didactic lecture with large groups of year twoundergraduate nursing students. With the addition use of pre and post lecture selfdirected study, this teaching medium provided an opportunity to enhance theoryintegration and also provide links to the TEL resources and simulated practicesessions.

Healthcare education providers are increasingly facedwith large cohorts of students, and must thereforeuse alternative ways of teaching and technology toensure that healthcare students acquire theknowledge and behaviours needed to improvepatient outcomes, safety & experience (DOH, 2011).Technology enhanced learning (TEL) is one solution,and using technology to enhance and supportlearning, teaching and student experience has gainedincreased momentum in recent years (Rapp et al.,2016). For this project, learning materials in the formof posters, podcasts and videos were created tosupport traditional didactic and simulation teachingstrategies. These were hosted on the “Skills forPractice” website, which provided flexibility andenabled students to access these resources, anytime,anywhere, on any device.

Simulation education is a bridge between classroomlearning and real-life clinical experience and has theability to provide students with authentic learningopportunities that foster engagement and deeplearning (DOH, 2011). It is a teaching method whichcan be used to improve the safety and effectiveness,by increasing self confidence and knowledge(Griswold et al., 2012). This project included the useof role play and human simulation in an environmentwhich resembled clinical practice. This enabled amore realistic and real time experience, allowing fordevelopment of technical and non technical skills.Special effects moulage makeup was also used tosimulate injuries and potential signs of a head injury,which added another dimension of reality andallowed students to practice communication andtherapeutic techniques.

The Kirkpatrick model is being used as thetheoretical framework to evaluate theblended learning approach as it isrecognised as the most well known andutilised model to evaluate health caretraining programmes. The model consistsof four criteria or levels of evaluation:

Reaction – content, materials and delivery

Learning – knowledge, skills and attitudes

Behaviour - application of newly acquired skills/knowledge

Outcomes - job performance, organisational change

(Kirkpatrick and Kirkpatrick, 2006)

The results from this research project will be published within academic journals anddisseminated at clinical and education conferences, in an attempt to raise awarenessof the strengths and limitations of using a blended learning approach, for the transferof knowledge and level of skill competence. The results will also promote the use TELand simulation initiatives and may inform future developments.

The mixed methods will include sessionevaluations to assess reactions; pre and postsession questionnaires will be used to assesslearning; focus groups will be conducted at theend of all three sessions and at the end oftheir acute placement to assess behaviour;outcomes will be explored within focus groupsat the end of their placement for students whohave completed neurological observationsduring their placement.

All 300 nursing students undertaking the level5 acute/critical care nursing module (NS0516)will be asked to complete questionnaires andan evaluation at the end of the sessions. Thesample for the focus groups will include aminimum of 15 students.